Two Month Review
Exit this survey
1
. General Information
General Information
Name:
Healthcare Facility:
Designation:
Please note: All responses are confidential
2
. Please select the most applicable responses to the statements below:
N/A
Strongly Disagree
Disagree
Somewhat Disagree
Neutral
Somewhat Agree
Agree
Strongly Agree
I am adapting well clinically for work in S.A.
*
Please select the most applicable responses to the statements below: I am adapting well clinically for work in S.A. N/A
I am adapting well clinically for work in S.A. Strongly Disagree
I am adapting well clinically for work in S.A. Disagree
I am adapting well clinically for work in S.A. Somewhat Disagree
I am adapting well clinically for work in S.A. Neutral
I am adapting well clinically for work in S.A. Somewhat Agree
I am adapting well clinically for work in S.A. Agree
I am adapting well clinically for work in S.A. Strongly Agree
I am adjusting well to the culture in rural S.A.
I am adjusting well to the culture in rural S.A. N/A
I am adjusting well to the culture in rural S.A. Strongly Disagree
I am adjusting well to the culture in rural S.A. Disagree
I am adjusting well to the culture in rural S.A. Somewhat Disagree
I am adjusting well to the culture in rural S.A. Neutral
I am adjusting well to the culture in rural S.A. Somewhat Agree
I am adjusting well to the culture in rural S.A. Agree
I am adjusting well to the culture in rural S.A. Strongly Agree
I am successfully navigating logistics in rural S.A. (finances, transport etc)
I am successfully navigating logistics in rural S.A. (finances, transport etc) N/A
I am successfully navigating logistics in rural S.A. (finances, transport etc) Strongly Disagree
I am successfully navigating logistics in rural S.A. (finances, transport etc) Disagree
I am successfully navigating logistics in rural S.A. (finances, transport etc) Somewhat Disagree
I am successfully navigating logistics in rural S.A. (finances, transport etc) Neutral
I am successfully navigating logistics in rural S.A. (finances, transport etc) Somewhat Agree
I am successfully navigating logistics in rural S.A. (finances, transport etc) Agree
I am successfully navigating logistics in rural S.A. (finances, transport etc) Strongly Agree
I am integrating well socially at the facility.
I am integrating well socially at the facility. N/A
I am integrating well socially at the facility. Strongly Disagree
I am integrating well socially at the facility. Disagree
I am integrating well socially at the facility. Somewhat Disagree
I am integrating well socially at the facility. Neutral
I am integrating well socially at the facility. Somewhat Agree
I am integrating well socially at the facility. Agree
I am integrating well socially at the facility. Strongly Agree
Additional Comments
3
. Did you attend the contact orientation session?
Did you attend the contact orientation session?
Yes
No
4
. If you answered "Yes" above, please select the most applicable options for the statements below.
The following were effective in preparing me clinically,culturally and or logistically for life in South Africa:
N/A
Strongly Disagree
Disagree
Somewhat Disagree
Neutral
Somewhat Agree
Agree
Strongly Agree
Social events (networking,dinners etc)
*
If you answered "Yes" above, please select the most applicable options for the statements below. The following were effective in preparing me clinically,culturally and or logistically for life in South Africa: Social events (networking,dinners etc) N/A
Social events (networking,dinners etc) Strongly Disagree
Social events (networking,dinners etc) Disagree
Social events (networking,dinners etc) Somewhat Disagree
Social events (networking,dinners etc) Neutral
Social events (networking,dinners etc) Somewhat Agree
Social events (networking,dinners etc) Agree
Social events (networking,dinners etc) Strongly Agree
Communication support (getting cell, internet etc)
Communication support (getting cell, internet etc) N/A
Communication support (getting cell, internet etc) Strongly Disagree
Communication support (getting cell, internet etc) Disagree
Communication support (getting cell, internet etc) Somewhat Disagree
Communication support (getting cell, internet etc) Neutral
Communication support (getting cell, internet etc) Somewhat Agree
Communication support (getting cell, internet etc) Agree
Communication support (getting cell, internet etc) Strongly Agree
Finances (opening accounts,acquiring insurance)
Finances (opening accounts,acquiring insurance) N/A
Finances (opening accounts,acquiring insurance) Strongly Disagree
Finances (opening accounts,acquiring insurance) Disagree
Finances (opening accounts,acquiring insurance) Somewhat Disagree
Finances (opening accounts,acquiring insurance) Neutral
Finances (opening accounts,acquiring insurance) Somewhat Agree
Finances (opening accounts,acquiring insurance) Agree
Finances (opening accounts,acquiring insurance) Strongly Agree
Transport (getting a car,airport pick up, transport to facility)
Transport (getting a car,airport pick up, transport to facility) N/A
Transport (getting a car,airport pick up, transport to facility) Strongly Disagree
Transport (getting a car,airport pick up, transport to facility) Disagree
Transport (getting a car,airport pick up, transport to facility) Somewhat Disagree
Transport (getting a car,airport pick up, transport to facility) Neutral
Transport (getting a car,airport pick up, transport to facility) Somewhat Agree
Transport (getting a car,airport pick up, transport to facility) Agree
Transport (getting a car,airport pick up, transport to facility) Strongly Agree
Is there anything for which you were unprepared/inadequately prepared that we should include in future contact orientation sessions?
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